Opening Pandora’s Box: A Case for the Enhanced Audiology Assistant

By Kevin Liebe, AuD

We’ve heard the calls. We’ve seen the stats. We need assistants in audiology.

As I had alluded to in a previous post, we simply do not have enough audiologists to “fill the gap” between supply and demand. A long-term gap could even potentially risk the creation of a new breed of professional, which I refer to as quasiologists.{{1}}[[1]]Quasiologists are individuals sometimes confused with audiologists by the general public who may perform similar or seemingly related services to those of audiologists or other hearing healthcare professionals. Please refer to my previous post on the subject: the Rise of Quasiology.[[1]]

Statistically speaking, audiologists are poised to see a significant uptick in the number of patients in need of their services in the coming decades. Simply due to the “graying” of the US and much of the rest of the industrialized world, the need for hearing and balance related services will undoubtedly increase. Without enough audiologists to keep up with demand, assistants will likely be used in greater numbers (and possibly with increased roles and responsibilities) in the future.

In a timely piece recently published in Audiology Today, Dr. Barry Freeman discusses the use of support personnel and assistants in other professions (Dentistry, Optometry, Veterinary) and lessons audiology can learn from their success:

“Dentists also have integrated revenue-generating support personnel into their practices. Patients are scheduled to return for routine hygiene appointments,and, in most instances, the patient is seen by a dental hygienist or dental assistant. Most audiologists do not employ technicians who can perform routine exams and charge for those services. Similarly, dentists use the expertise of their front-line and support personnel to perform non-revenue producing, but critical tasks within their practice. Generally dentists do not personally discuss hygiene, payment options or routine treatments such as the use of dental floss.”

Has the time come for us to really reconsider how we are utilizing assistants in the audiology clinic today?

Fulfilling the Need

While not a new concept, the popularity of utilizing assistants in the audiology clinic has grown in recent years. They have been used successfully in some capacity in nearly all settings, from the VA to the private audiology practice. However, one of the biggest impediments to the establishment of a well-defined Audiology Assistant (AA) is that we don’t all seem to agree completely about what an assistant can and cannot do.{{2}}[[2]]The American Academy of Audiology has issued position statements on Audiology Assistants, however, few states presently regulate or define the scope of practice for audiology support personnel. Plus, many tasks performed by assistants in audiology are not billable, unlike many assistants in other professions such as dentistry, medicine, etc.[[2]]

Assistants can help audiologists improve efficiency in the clinic. Image courtesy Buzzle
Assistants can help audiologists improve efficiency in the clinic. Image courtesy Buzzle

This partly explains why, except perhaps for the military and VA, there are very few audiology assistant training programs.{{3}}[[3]] I’m aware of only a single program  offered through Nova Southeastern University. An overview of their distance learning program for Audiology Assistants can be found here.[[3]]Furthermore, few states have certification or licensure requirements for assistants.

While many states do not regulate support personnel in audiology, some states, such as Massachusetts, require AAs to have at least an Associate’s or Bachelor’s degree in audiology in order to practice.

Career Prospects and Earnings

Median wages for audiology assistants have been estimated at around $40k per year. Not bad, but not that great for a long-term career either–especially if you are required to have a Bachelor’s degree to practice in some states.

The numbers I’ve come across and heard of anecdotally, however, vary widely. I’ve heard of assistants being paid anywhere from minimum wage to maybe $17-$18/hr at the upper end. Understandably, many of the discrepancies in earnings are directly related to the job duties and responsibilities of the assistant. This poses a real dilemma:  How can we require “more” from audiology assistants (such as requiring an Associate’s or Bachelor’s degree) and yet pay them significantly lower wages than they would earn as hearing instrument specialists (HIS), an occupation that takes significantly less formal training and has earnings frequently on par with audiologists?{{4}}[[4]]Licensure for HIS professionals can often be obtained after an apprenticeship and passing of a practical exam. Self-paced training is commonplace during the apprenticeship component; it can take less than 6 months in some cases to complete, but standards vary by state[[4]].

Careers as a PT or OT assistant are growing at breakneck speed, and they are reasonably compensated: $23-25/hr.

Would enhancing the duties and responsibilities of AA's be a wise move?
The Enhanced Assistant: Smart Move?

If we really want audiology assistants to be for us what the Physical Therapy Assistant (PTA) or the Occupational Therapy Assistant, etc. is today for those professions, then we may need to rethink what the job duties of an AA are now and what they could be in the future.

Enhanced Assistants: Glimpse of the Future?

As I mentioned earlier, there is a wide range of responsibilities that AAs and technicians are currently performing in audiology clinics nationwide. Maybe it’s time,  in audiology, to expand formal training programs for AAs to allow for the equivalent of Board Certification (such as we have in audiology with Cochlear Implants, Pediatrics, etc.). These hypothetical certifications could include: audiometry, vestibular, auditory rehab, etc.

Maybe these types of proposals are bordering on quasiology… or maybe taking a serious look at such a proposal is long overdue.

Stay tuned: Next week we’ll discuss these “enhanced” assistants in more detail and consider how they could potentially improve efficiency in the audiology clinic.

  *title image courtesy insanelymac.com

_


About HHTM

HHTM's mission is to bridge the knowledge gaps in treating hearing loss by providing timely information and lively insights to anyone who cares about hearing loss. Our contributors and readers are drawn from many sectors of the hearing field, including practitioners, researchers, manufacturers, educators, and, importantly, hearing-impaired consumers and those who love them.